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皖南医学院弋矶山医院超声科
纸质出版日期:2024,
网络出版日期:2024-3-4,
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练菲菲, 刘表虎, 纪文艳, 等. 四维自动左房定量技术评价不同透析方式对尿毒症患者左房结构和功能的影响[J]. 临床超声医学杂志, 2024,26(2).
Evaluation of the effects of different dialysis methods on left atrial structure and function in uremic patients using four-dimensional automatic left atrial quantification technology[J]. Journal of Clinical Ultrasound in Medicine, 2024,26(2).
练菲菲, 刘表虎, 纪文艳, 等. 四维自动左房定量技术评价不同透析方式对尿毒症患者左房结构和功能的影响[J]. 临床超声医学杂志, 2024,26(2). DOI:
Evaluation of the effects of different dialysis methods on left atrial structure and function in uremic patients using four-dimensional automatic left atrial quantification technology[J]. Journal of Clinical Ultrasound in Medicine, 2024,26(2). DOI:
目的 应用四维自动左房定量技术(four-dimensional automatic left atrial quantification
4D Auto LAQ)分别从容积和应变角度评估不同透析方式对尿毒症患者左房结构和功能的影响。方法 选取在我院肾内科确诊尿毒症患者80例
并根据透析方式分为血液透析组41例(血透组)和腹膜透析组39例(腹透组)
另选取与其性别、年龄相匹配的健康体检者35例(正常对照组)。应用二维超声心动图检查获取常规参数:左房内径(LAD)、左室舒张末期内径(LVEDD)、室间隔厚度(IVS)、左室后壁厚度(LVPW)、左室射血分数(LVEF);应用4D Auto LAQ获取左房应变和容积参数:左房储备期纵向应变(LASr)、左房管道期纵向应变(LAScd)、左房收缩期纵向应变(LASct);左房储备期环形应变(LASr-c)、左房管道期环形应变(LAScd-c)、左房收缩期环形应变(LASct-c);左房最大容积(LAVmax)、左房最小容积(LAmin)、左房收缩前容积(LAVpreA)
左房射血分数(LAEF)
比较上述组间参数有无差异
分析4D Auto LAQ应变和容积参数间有无相关性。结果 ①常规参数:腹透组和血透组LAD、LVEDD、IVS、LVPW较正常对照组增大
差异有统计学意义(P<0.05)
各组间LVEF差异无统计学意义(P>0.05);血透组和腹透组LAD、LVEDD、IVS、LVPW差异无统计学意义(P>0.05);②应变参数:腹透组LASr、LAScd、LASr-c、LAScd-c较正常对照组减小
LASct、LASct-c较正常对照组增大
血透组LASr、LAScd、LASct、LASr-c、LAScd-c、LASct-c较正常对照组减小
差异有统计学意义(P<0.05);血透组LASr、LASct、LASr-c、LAScd-c、LASct-c较腹透组减小
差异有统计学意义(P<0.05)
两组间LAScd差异无统计学意义(P>0.05);③容积参数:腹透组和血透组LAVmax、LAmin、LAVpreA较正常对照组增大
LAEF较正常对照组减小
差异有统计学意义(P<0.05);血透组LAVmax、LAmin、LAVpreA较腹透组增大
LAEF较腹透组减小
差异有统计学意义(P<0.05)。在相关性分析中
LAEF与LASr、LAScd、LASr-c、LAScd-c的绝对值呈正相关
相关性系数分别为0.531、0.522、0.705、0.686。结论 4D Auto LAQ可以评价不同透析方式对左房结构和功能的改变
血透较腹透对左房结构和功能影响更为显著。
Objective Four dimensional automatic left atrial quantification (4D Auto LAQ) was applied to evaluate the effects of different dialysis methods on left atrial structure and function in uremic patients from the perspectives of volume and strain
respectively.Methods 80 patients with confirmed uremia in the nephrology department of our hospital were selected and divided into a hemodialysis group of 41 cases (hemodialysis group) and a peritoneal dialysis group of 39 cases (peritoneal dialysis group) based on the dialysis method. Additionally
35 healthy individuals who matched their gender and age were selected (normal control group).SConventional parameters were obtained by two-dimensional echocardiography: left atrial diameter (LAD)
left ventricular end diastolic diameter (LVEDD)
interventricular septum thickness (IVS)
left ventricular posterior wall thickness (LVPW)
left ventricular ejection fraction (LVEF);SUsing 4D Auto LAQ to obtain left atrial strain and volume parameters: left atrial reserve longitudinal strain (LASr)
left atrial ductal longitudinal strain (LAScd)
and left atrial systolic longitudinal strain (LASct);SLeft atrial reserve phase circumferential strain (LASr-c)
left atrial ductal phase circumferential strain (LAScd-c)
and left atrial systolic phase circumferential strain (LASct-c);SLeft atrial maximum volume (LAVmax)
left atrial minimum volume (LAmin)
left atrial pre-systolic volume (LAVpreA)
and left atrial ejection fraction (LAEF) were compared for differences in the above group parameters
and the correlation between 4D Auto LAQ strain and volume parameters was analyzed.Results ① Routine parameters: LAD
LVEDD
IVS
and LVPW in the peritoneal dialysis group and hemodialysis group increased compared to the normal control group
with a statistically significant difference (P<0.05). There was no statistically significant difference in LVEF between the groups (P>0.05);SThere was no statistically significant difference in LAD
LVEDD
IVS
and LVPW between the hemodialysis group and the peritoneal dialysis group (P>0.05)SStrain parameters: LASr
LAScd
LASr-c
and LAScd-c in the peritoneal dialysis group decreased compared to the normal control group
while LASct and LASct-c increased compared to the normal control group. LASr
LAScd
LASct
LASr-c
LAScd-c
and LASct-c in the hemodialysis group decreased compared to the normal control group
with a statistically significant difference (P<0.05);SThe LASr
LASct
LASr-c
LAScd-c
and LASct-c in the hemodialysis group were significantly reduced compared to the peritoneal dialysis group (P<0.05)
and the difference was statistically significant (P<0.05). There was no statistically significant difference in LAScd between the two groups (P>0.05)SVolume parameters: LAVmax
LAmin
and LAVpreA in the peritoneal dialysis group and hemodialysis group increased compared to the normal control group
while LAEF decreased compared to the normal control group
with a statistically significant difference (P<0.05);SThe LAVmax
LAmin
and LAVpreA in the hemodialysis group increased compared to the peritoneal dialysis group
while LAEF decreased compared to the peritoneal dialysis group
with a statistically significant difference (P<0.05).SIn correlation analysis
LAEF is positively correlated with the absolute values of LASr
LAScd
LASr-c
and LAScd-c
with correlation coefficients of 0.531
0.522
0.705
and 0.686
respectively.Conclusion 4D Auto LAQ can evaluate the changes in left atrial structure and function caused by different dialysis methods
and hemodialysis has a more significant impact on left atrial structure and function than peritoneal dialysis.
左房四维定量分析透析尿毒症应变容积左房功能
Four dimensional quantitative analysis of the left atriumDialysisUremiaStrainVolumeLeft atrial function
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